HomeMy WebLinkAbout01-0099
BUILDING PERMITN2
0099
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
Date _
2/7/0 f
. ,
BUI~NG
ElEC~AL
PlU~NG
&.../ o. r!5d
MECHANICAL
Sewer Conn
Water Conn:
Property Owner: Do,", ~ (J k.eYl S
Job Address: So '2. "I 9~ St.
Parcell.D. # I \~ 2~- 21- C) 0 to - 1 '1..00 - D" 0
Zoning: ~nergy Code:
DescriPtion of Work A / (.... ~^ j Q 0 ~
Water Meter:
T.I.F.'s:
Radon Gas:
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
.5"- I c::> - <::J
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
~oV
Permit Fee v......., '.
, Signatur ~
Company
Address
- Telephone# <6\2> . nS 4]q~
Valuation or "7.D 0 I . ~
Contract Price .=1 J
City license Registration #
State Certified license#
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SlB
Tub Set
Water
Sewer
Final
~-+ " A. ') ,...
Loof.'"c..
MECHANICAL 7
Ftr.
Pre SlB
lintel
FRM.
Insul. Cl
Wl
ElE
Breakers
Ducts Insl.
Compressor
Final
Driveway
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Twenty Five and 00/100 Dollars ($25.00) shall be made for each trip for each trade:
a. Wrong Address
b. Condemned work resulting from faulty construction.
c. Repairs or corrections not made when inspection called.
d. Work not ready for inspection when called.
e. Permit not posted on job site.
f. Plans not at job site.
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
crr.rY OF ZEPH)~ILLS PERMI~ APPLICATION
8unS;'Uf(;1 r},!,i;1;'M'fl-mNT 1313-'788-'6611 FAX: .U3.-'188-1!S16
DATE RECElVED---~,~,~-
PJ..hN3 R8V I EW FE E
~WNE!~." s NANE..12DJ:J..J?t~BQ~.~..2li~?_"_.___".,,_._.~__" PHONE.$l Q . 7<g<g. Ilc.[-S
10/3 A.L:DPf~:::"5l>~~g,#?.$t~,"...~pb!fhLU2~_..EL_L_~~f2.qQ~_~.__._...,.____.__.___..
LSGAlJ DF.:3I:;RIPT 1 on :LO'f I 'S..I BLOCK
STJBLIIVrSION
P l\~GE, LID # Jl.:.;!;lt?..:..~: O12L Q.~..~J~..~..91.l.Q_.___.._.._._J.Q~U"I,.N. __E'B.QM...eBI~.a!L~.....NiU:.I.CEL_
o q ~./'l>l\"
'w) .1. ',1. j
t~J ~I ()1"ll:
~ALTERATION
CJ DEMor,lSH
o REP;1\IR
o INSTALL
'fORK PROl?Sfm~ O!:,fli.W (:~.::PSTF.UCTI()N
[] i\DDlTION
PROPCSED USE::: )Kf:3Gr, ;'Ar-~U~Y 1)\~r.L:,i.,iG
[lHULl'I - P'}"MILY
Un OF UNITS
o HOB I r...E HOME
o OTHER
o c.c\<'m:HC 5)."-\.,
o INlJU5TFIAl,
OSWIMMlNG POOL
C:J RE:;TAlIHJ\J'i; ':- HE;ALTH DSFARn1ENT l\?PHiYoJAI"
ct~'~~; i~~~ALcio_3,'dc{LJd~.!11L~~-Lfu~UJant5 eJq5li'1j
13L:JLDING SI::'Ji; __~._._,~__~~_.._,"..~,_A,___n.... SQU,i~.RJ{ F'(lO'l'AGE: ^____.__.~~_, KEIGHT ~
RF.:~~IN:NTJ:AL~ .7-1.'1'T1"'.C1'; ('2) ?J.//r".,.",H~:~ !; U) S::<:'TS OF RUILJ:)IN(') PI,f'.\.l'i'S & (1) SET ENERGY FORMS.
'~\:",'\- 1AL ; AT"ri),1~'H ('3) 5[';'1'2 CW -P,,! I U) ING iL!\N:3 ,~< (L \ SET ENEP8YFORHS.
;;--B.CPb:r"'TI SUiWF.Y F~F,(::UTFid,) E'OP I\l,L NE~~ CC)NST?UCTION.
~ERMITS REQUESTED
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[] BUILDING
o E;LEC'1'RIC,~L
$,,~.~---_~_~_.._>~_".~~",_._.~, VALFATION or TOTAL r:.:O!"STR(K~TION
.,_~_~_,.,,,",~,"l;.N'P' :5FPVl C::S
[J FLOHIDh PC.HER
(] W.R,E,C.
LJ FL~1t.1P:rl,;r:;
~ HECH~\i\HCAL
;E;_...~~l~."_"__""~_.._".._ VAJJU},\Tl<JN OF :tl'YClll',lJCIAl, INS'T.ALhl\.'l'10N
[J GAS
Cl Roon Nl~
1] s p~::,:' r ri..;!U
Lj C',fl"HEP,
TYPE:; OF C"t,j~;rp.Ll~':J'"J)N: U i:~L\XK
CJ P'B.ANE
[J STEEL
[1 OTH'I<:;R
F all SHED t,J:,OOP ~~ L:E V}!,. T [!.'::n_".,___.._"....~,."...___
IS PRO,JE,CT IN 'F'LOCL! ZOl~E AREAD YES
[) NO
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BUILDER
S 1 GNA'.l'URE ____'^_~""
cor.U'./.\N 'f ---"__~___,__~___~.
STATE C8~I OR REGIST #
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STJI.'rr, G~r<'r OF R€GIST #
CITY PROCESSING #
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CO!'iI);'i'lC:f~~; OF PERI"JIT AFE'IL'\Vl't
A. NCnIGE Of DEEr RESTRICTIONS
The unde.t.sign"~d 1..1r,d~,rsti:)nde t.hat. trt5.,'" permit may be lsub-; ect 1:.0 "deed restrictions" whid,
may be more r~3trictive than City rsqulatiohs. The under~~qned assumes responsibility tor
complianc~e "ii 1:1: any appL\.cable .j",oe.d :t:est..rictions,
B. UNLICENSED CC';'I'1'.FAC'1"),R,S ,-<.NL! \:;OtnRi'l'~'[.JR RE:SPONSTBILITIEiS
Jt the owner hag hi~~d ~ contra2toL cr contractors to undertake work, they may be required
1:.0 be li':::,;,ns~d in ,,,,cc<:)Y.::d<'tflce with 51.~.:,te ~'\nd local .r.~gul"'t:j>o.ns. If: th(:- contr<!.ctor is not
licensed as requ~red by law, betn th@ Oinle~ and CQn~raCCcr m~y be cited for a misdemeanor
viol,,,ti()Jl tUlde:.', st.'"-t~) .1.!il.~\1_ It i:.h~' G,m.eI::O.1: i.ntended contr?tc'::o!:. 2l.U~ un'~...rt:ain as to what
licensinq .t~quire:nent.B ma.y cq::-ply for.: the: intended ~~().1:k" the:y ace adv:u9'ed to contact the
Cj.. ty of Ztephy rhills .8ui 1 ding 1);-:pi:1!::tm",'1J i~, e13 .-7 86,- 661 J. .
Ftu:thfr.t:mol.':', it U'v" oI-In.eJ: !ret,'" hired ,,'..::ODC.!.acto.t ox: cont-::<'lct(,>.r.~, he is advised to have t.he
(:<)nttacto!: (8j si.gn port.ions yf. tl'1.f: ".ConLl.'acto:t' Sectionfjl" of this application for which they
will be responsible:_ If Y<:.>'l, <l~ i:;hl.') (i~m",.t. (11qn:;l <:\.:::> the cont.ractor, you are indicatJng t.hat
you, rath$l tl.H'tll the coot.t:c'tct.o.t:, i:ne re3pOTLsib1t:: 1":H t:0~ Hox.k. I:~ the contractor wishes
you to sign dB contl:actc'.l t.I121.':. may bfo an \l)cii.,.~at:.i.on 1':.1-:<<1:'. h.... i.5 not properly licensed and is
nc:t en ti t l.t3:d i~Q pe Lvd. t; L;L!l',1 p.t i 'I iJ.etje5 in the Ci. ty of '~:eptlY d'l.l.ll s '
C. 'l'RANSPORTA'TJ.OfJ IMP.hCT H'EE;.s .!:IN): tiTIi..i.T\' CONNECTION fEE::;,
D. CONSTPlJCTUIC'N LJF:.tl LAiv :, r::t.'AP'I'ER ,P, FLORIDlI. S],ATUTf~~'i A.SA1iJI<~ND.ED)
J ce!:tify tha~.: 1" the appl.i.c':l.nt., have b""en provided lrr~th a Cqpy ot "Fl,,n:icta'::; Construction
.li.en 1;8.~1 - Home.oTrme!:"" 51. Protl":ctir)li Glv.d<>." p:(~pi;\red by the FlorJ..ds. Department of Agriculture
and, COH$Um"'.t AffaLLe;. l { the a.PF.L.cant. i:~ someone od)f:~r th"lt the "ovmf;!!:c"/ I (~~ri fy that I
have obtcdned ,,:\ cO'py of the above desc1;.l.b.:::d C1CC:tlW""nt:: ;~nd pn)I~~J.:::.e in g.ood faith to deliver
it to the "ownetU prlor to C0Mnen~ern~nt.
J;;, CON'1'F<..i'\C'1'OH' B!CWiHER' r5 l-\.rq;.L 01\.\/JT
I certify tha.t all. the J_nfot:!n",t~J.c1'l i.l.'. Uu.:" ~pp).J.catl!)n1.$ dCCUrate and t.hat all Nork '-'1ill
be done Ln ~ompliance with all applicable laws regulat~ng cooMtruction, zoning, and land
1'.1 :-:l..r~~ 1 ':)prnc.r'l t. ~
Appl:!.I::at.tor;',.s r,'i';,teby trli'lde to obts.i'.l .'1 peJ:mit t.Q do \-'!ork .3.nd installat.i.on as indicated. I
coe-.t:tify t.hi~.t no \.,ork ox .Lnstal.L.'x.i..cn h,:t,~ '::oJ11menr::e:d. p.D.c.,r to is~uElnce of a permit and t.hat
al.l ,~ork J..J L1.. be pe.tfQnl)~d to !!Iht:r gt~iTl(i;:i\K'd-;; of all 1a\.>7t5regulaU.:n.9 eonstruction, City
~X)de$" z(;rd.ng :re9111atian.s. ;:>,nd i.C'.n~: ,:L,,:'.relc'Fment requL3tions in t.he ]urt.sdi,ctton. I also
ce.r:t.ify th..:t.t 1. unde.t:sLuv.:l. ~:.h",.t tl.:e'J1qul21t.tons of OLb~! gov(;'!.rruo(",nt.al a~Jencies may appl~r' to
':;he .i.))t.!~ndo!~d ;.un J.'; , i;tnd thftt it is wy l.'e,sp')I1;;;ib:U.lty to identify what actions I must t,ake 'Co
b(; It, ('OJllp.l..i.aIlC17-, S1.\'.~h agencie.$ 3.w::.1.ude but. aI:e not. Jimited to: "Depa:r:tment of
Environmen tal Pegula tion-Cypress' B~yr'e-'3'..ls, vleLland AXe.>i.'\$ and Envj.Lonment.ally 3enP.o1.ti ve
Lands, Water/Wa3te~~ter TreaLmenc
*Sout.hwest f"lo.t:id.a h1atel; t,j;:l.lv;qf~ml":'nL Dist;.oct;-\'lell:>:, Cypr~ss8ayll~!~d$, i'ietla.nd Areas,
Altering W~ts~cOUr9~9
*Anoy Corp~ of Enqineer9-Seawalls, DockB. Navigable Waterways
"Depaxtment of Rea:! th " R.ehl'biU.ta.t::L';"e: Senric:es.,EnvJ_r()nm~nt.."ll Health Uni.t-VfelJ.s,
\'1a.'31:.eNdter Treatment, Sept..lc TaJlkEJ
"'U.S. Environmer,tal Pu:>t:f::ct}.on P,genc'/-Asl.:,,",st.os abatement
I also Cett1 ty th9t~f .i.t fill )na~et'l.a_. 1', t.o be q$ect in F'l:)od lJ(lne "1\" (~r ",1:>,., etc." f it is
understood that & dULi.f\dqe pJ.an ';H:tdn:3sinq3"compens;3.t..lng volume" will be submit.ted which
lS pr.epated D',i a p.rC>t~es:'.n..,)n.:"J. '?:nq,:ul""':r.: I;'=qtst{~red ~n the State of Flor:Lda prior to permit
J .5~;u,?'n('e ~
1\ pe1.'Tn.it .i.s~t.1(:d sha..U. be construe.d to be .;3. licen;se to p.r:oceed '......ith the: work and not as
Cl\).tho:ctty to.;lo1ate, cancel, ,:'tJ.t:{~.t, ot' set a:;;.i.de any p,H}V1S.io~)~ of t.he techn\<:aJ codes,
nOl:: shall issuance of ,'l. pe.!:mj. t pre'fr.:;,nt che Building Offiei-3.1 f:cont thereafter requiring a
CQJ;tectton ot ettC).~:Sl'l pJ.a.DS, (:':0~)S,:.~:uct.i.on, 01' violi'l.ticns of any code, Every permit
issued shall become in',/.31::.'-1. unl",,~s the hork i!ll,2tho:'.:lzed by :SliGh p€!rmit 1s ':onunenced w.i.thin
six months (if j,,:~uance, CJ;. if 'Nol:k a,u.thori;'.fld by t:h,", permit is suspended or abandoned for a
pe.-.::icd of sil>: mOl'.sI.F:la:Lte:-.-' tb"" timE! 1:h"" 1<10!:K: .is oommenced" eme 90 da~r extension of time
:;nay be allcVI'ed for; the per.;Rlt ",~ith fee cha.rge ot ~~15"UO, ThEl ~;.:.te.nst()n >>haJJ. be requested
in wrltinq to the BUlld~ng Official, An approved inspection must be logged during each six
month period, ~)1: t:he pr:c.: e'C':; \"il.l bo:e r.:cme.idl'!!:<'!'d aband.0l'l'ed.
~lA.RN:rNG '1'0 OVJ1.iER: ,(CUR E'ATLURJ!: I'C> RECO?.D A. N()'l'lCE Of CU.~'il"H~~NCF':I'1ENT MAY RESUL'l' IN "fOUR
PAYING TWICE FOP H1f'POVEMEN'I':~ ''::0 ''{OU,~: PROPERTY, .U!' YOU TN'l'E.t,([I TO OBTAIN FINANCING, CONSULT
WITH YOUR I"E~NlJEH OR .PLN }\TTOFNEY 5E.f<JI.,E R,ECOP.DIW::: Y(Jf}:':1, NO'.nCE OF CO.lIllMEHCfJ!MENT, JOBS UNDER
~;2, :lOO TN i!j!LLlJE DO NOT NE:I'lD TO l,t>:COf<:JAND POST I'L >'NOTICE OE' COMr>1EHCEMENT",
~-~-
~;,
COHTRACTOR
STAT Ii' ()F' F'T rlRl i-I" , L. J Co 1/\
::()UN'~Y - ~~)F --:~=.=~~J1LL~__._..tz)U~r.L____.___.._
Th~ t01::eq,).!.n?l..'.:).'l~'.rj...n\Inent \:'~:.'C a_ClrD. oW.l'~dg~L. (
Betore me tIns Jim d3.Y O! ~~., ~
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(r-",'l.~:'i~_ of pr.-~l~.;'}n .~. -'~,-J'"'tr.~7'l~._r]. ~'d~H:-':_~ 1
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"'r ~ '1'" (.,~ 1"1")" I [)A d; J I... L _ ._
'~;~l~:Y.-'~F.-'-',-r<... _~~____._
The foregoinq in,s'ftument \r"ara~~r::.kClowledge(l
g(~for:;" me t:hi.:'~__day Of-t:~:JlQ~, ~.J~J
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